A Query On A Phone Call

The first job of our nightshift was to an overdose. Sometimes these are nasty, sometimes they are easy. Sometimes you know what the job is going to be like from the information sent down to our ambulance.

“55 year old man, overdose on diazepam and alcohol ?how long ?amount”.

My psychic powers kicked in and I predicted an alcoholic who had taken many tablets of a small dose of diazepam (a muscle relaxant and sedative) with rather a lot of alcohol. Probably nothing too serious in a physical sense, but it never hurts to get there as quickly as is safely possible.

The FRU was already there, along with the patient's sister. Our patient had drunk a *huge* bottle of whiskey along with around forty tablets of very low dose diazepam. He'd taken about double the daily dose which meant that he was going to be sleepy but it wasn't likely to be life-threatening. He'd still need to go to hospital to be sure and so he could have a psychiatric referral.

I asked the sister about the patient, was he a heavy drinker? She replied that he wasn't just a heavy drinker but that he was an alcoholic, it's not that I really needed to ask – one look at the patient's house told me that.

The patient had taken the overdose in the morning, then rung his girlfriend to tell her what he had done. She was out at work and so the message was left on the answerphone. In the evening his girlfriend had returned home from work, heard the message and phoned the sister who lived closer. The sister had called us and went around to open the door.

What I wanted to know was, did the patient really want to kill himself and left phoning his girlfriend until he knew she would be out in order to make sure he was dead before she got the message? Or, more likely, was he so drunk while taking the tablets that he didn't know what the time was when he made the phone call?

It never ceases to surprise me how people who take an overdose act. They take a handful of tablets, then phone a friend. They then act surprised when the ambulance arrives.

Thankfully this patient was drowsy and compliant (he was a big man and I didn't fancy wrestling him into the ambulance). He'd slept the day away, spent some time sleeping in the A&E department and the last I saw of him was him walking into the patient toilet.

So an easy job, a sensible sister and a puzzle on the nature of a phone call.

There might not be a post tomorrow – you'll find out why on Friday.

12 thoughts on “A Query On A Phone Call”

  1. ooh I hope it's nothing horrible which might prevent a post tomorrow? If it is, good luck and fingers crossed and it it's something nice, enjoy. I often wonder that about potential suicides as well – stuff yourself full of god knows what then “phone a friend” – bit pointless, really.

  2. Don't even get me started on “suicide” attempts. I've seen enough of them – real and fake.Example of “fake” – take some tablets, flush the rest down the toilet to make it look like you've taken more than you have. Leave a note to make sure someone will walk in and find you taking them. Get taken to hospital. Let your friends worry about you all night. When you get home in the morning ring round all your friends who missed the excitement to tell them what happened. I only wish I was joking.

    Example of “real” – pretend to take your medication each day but secretly save it up. Quietly take the whole lot in one go and wash it down with a pint of vodka. Kiss you wife goodnight and go off to bed alone. “Have you had a drink?” “Only a small one” Tell your psychiatrist a few months later when she asks if you've ever attempted suicide before.

    Example of “I don't want to kill myself but I can't cope and I really need some help” – take lots of tablets. Instantly regret what you've just done. Get scared, call a friend.

  3. Not really.If you phone a friend saying “I feel really depressed, I feel like I want to harm myself” then they might have time for a chat then and there, or tell you to come over to their house for some support and keeping an eye out for you… but they also might come out with “gosh, look, I'm sorry but I've got to go” or “I've got plans tonight, we'll have to get together at some point though” and never phone you back. Particularly if you ring them like this a lot.

    If, however, you phone a friend and tell them that you have taken an overdose, (in other words, that as well as the psychological upset there is now a serious and urgent physical problem that may result in a death), you will have their full and undivided attention for quite some time.

    That's the “point” for a fair few (not all) people in an overdose/phone a friend pattern, whether they are doing it on purpose or not, whether they realise they are doing it or not.

    I have sympathy for those who really are desperate and for whom this is the only way of getting *any* attention, and/or who don't realise what they're doing.

    The ones who piss me off are the ones with loads of family and friends around them being as supportive as they can be, who “fake it” – flushing tablets down the loo and then waving the empty container at everyone, etc – with no regard for the upset they are causing to those who care about them, simply because someone else has been ill/had a birthday/got good exam results/whatever, and has temporarily ousted them from the centre-of-attention pedestal.

  4. “I want to be dead, but only for a couple of weeks, or until this trauma goes away.” Nobody has ever actually said that to me, but, after all these years, I believe that it is a common motivationTrouble is, you o/d and you sleep for a couple of weeks, then you wake up, and it is as if no time at all had passed; the trauma is still there. Ian Huntley's “Oh, God, no!” when he awoke comes immediately to mind.

    We used to wash people out on the basis that:

    a. It helped preserve life.

    b. It was so unpleasant that “attention seekers” would not wish to undergo the experience twice.

    A study in Scandanavia showed that (b) was spot on – but not because washing out made people o/d no more. On the contrary, it made them make sure that they would do a proper job the next time!

  5. I must admit I've done the last one myself. I was 18, desperate and confused. I kept arguing with my family, failing job interviews and about to lose my best friend because he was off to uni. So I OD'd on ibuprofen. I took a pack of 16, and washed it down with Smirnoff Ice. I immediately realised what I'd done, so I phoned my friend who came straight round and spent all night in A&E with me. I'm a hell of a lot happier now, thanks to the psychatric nurse who reasurred me I wasn't the only one who felt alone, and gave me the number of a local youth club. Of course I regret what I did, because I must have worried my friend a great deal, but by taking that overdose I got the help I needed.

  6. When I worked at A&E we got the same people in week after week with “overdoses”. They knew exactly how much to take to get a night in hospital but without doing any serious harm. Most of the time I think they were just doing it to continue to claim benefits, “I am depressed as I've tried to kill myself 6 times in the past month”.

  7. nasty thing about trying to commit suicide by overdose is that its not like gunning yourself down to death (not that i tried this method, but its pretty obvious how quick suicide is by a gunshot anyway), lots of nasty effects after one swallows the pills. but then, i think you guys know that already. but if it was the first time he had an overdose, he probably didnt know what was coming.some ppl think of suicide and suddenly hated it when they commit it. lucky are those who were unsuccessful at it.

  8. There are those that take the proverbial.Those who are at their wits end and can see no other way around their acute life situations and who succeed in dying.

    It takes courage to do the latter and even more courage to live and deal with it.

  9. you don't think that maybe they felt like they needed extra help and to be kept safe?no, it seems very few people do ever consider that possibility. its much easier all round to believe that they're time wasters and just after the “benefits” (believe me there are MUCH better ways to continue to claim benefits).

    unfortunately, the mental health system is such that simply saying “I feel unsafe, please help me” isn't enough. the big problem, is that most people can easily find out what dose they can take and not kill themselves, but they don't realise the long term damage they are doing to their system.

  10. Behaviour that is rewarded, tends to be repeated.If an overdose that isn't life-threatening gets a reward of increased attention, safety, etc, then certain people will do it again and again and again.

    Despite the feeling sick, and despite the long-term effects, and despite the impact such behaviour has on friends and family, including when friends and family end up with their own mental health problems as a result of running around and worrying about the overdoser.

  11. I totally agree.I wonder how many people have thought “I wish I hadn't done this” and then died.

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